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Clinical outcome and predictors of treatment response in foam sodium tetradecyl sulfate sclerotherapy of venous malformations

  • Interventional
  • Published:
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Abstract

Objectives

To evaluate clinical outcomes and their predictors in patients with venous malformation (VM) treated with foam sodium tetradecyl sulfate (STS) sclerotherapy.

Methods

We retrospectively evaluated clinical outcomes of foam STS sclerotherapy in 86 patients with 91 VMs to assess reduction in pain and mass after treatment. Univariate and multivariate analysis was performed to determine possible predictors of clinical outcome with foam STS sclerotherapy.

Results

A positive response of 49.5 % in pain reduction and 52.7 % in mass reduction was observed. The numerical rating scale (NRS) score improved from 4.36 ± 2.64 to 1.74 ± 1.57, and VM mass volume decreased to 41.7 ± 35.52 % of the initial size. On multivariate analysis, a high baseline NRS score (odds ratio: 1.12, 95 % confidence interval: 1.09–1.15) and VM location in the trunk versus the head and neck (odds ratio: 1.30, 95 % confidence interval: 1.00–1.69) were positive predictors of pain improvement. Minor complications occurred in 11 (12.1 %) patients and recurrence in 12 (13.2 %) patients.

Conclusions

Foam STS sclerotherapy is an effective treatment in venous malformation, with low complication risk. A high baseline NRS score and location in the trunk versus the head and neck were positive predictors in improvement of pain.

Key Points

• Foam STS sclerotherapy is effective in VM, with low risk of complications.

• Relief of pain tends to be dramatic in patients with severe pain.

• Location of VM is a predictor of pain improvement.

• The presence of a draining vein does not affect foam sclerotherapy.

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Abbreviations

VM:

Venous malformation

VMs:

Venous malformations

STS:

Sodium tetradecyl sulfate

NRS:

Numerical rating scale

ADLs:

Activities of daily living

AVM:

Arteriovenous malformation

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Acknowledgments

We thank Siunna Baek for editing this manuscript.

The scientific guarantor of this publication is Young Soo Do. This study received funding from the Samsung Biomedical Research Institute (grant #SMX1150261). Institutional review board approval was obtained for the retrospective review of patients’ medical records and radiologic images, and for the questionnaires and interviews used to obtain data. Written informed consent was not required as this was a retrospective study. Methodology: retrospective cross-sectional study/observational, performed at one institution.

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Authors and Affiliations

  1. Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Ilwon-dong 50, Kangnam-gu, Seoul, 135-710, Korea

    Hong Suk Park, Young Soo Do, Kwang Bo Park, Keon-Ha Kim, Dongho Hyun, Sung Ki Cho & In Wook Choo

  2. Biostatistics Team, Samsung Biomedical Research Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

    Sook Young Woo

  3. Biostatistics and Clinical Epidemiology Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

    Sin-Ho Jung

  4. Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

    Dong-Ik Kim & Young Wook Kim

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  1. Hong Suk Park
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Correspondence to Young Soo Do.

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Park, H.S., Do, Y.S., Park, K.B. et al. Clinical outcome and predictors of treatment response in foam sodium tetradecyl sulfate sclerotherapy of venous malformations. Eur Radiol 26, 1301–1310 (2016). https://doi.org/10.1007/s00330-015-3931-9

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  • DOI: https://doi.org/10.1007/s00330-015-3931-9

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